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Any ideas? Bouncing bg

Yes CarbsRok you are a little harsh and your last sentence is a wild generalisation. Engineer has been on a pump only a little longer than me and has been full of good advice with regards to the pump. For all we know there might be something going on in the background that hasn't been picked up on, either by us or by Engineer, or as we know can happen, Engineer's basal needs may have changed. People come on here for advice, not to be criticised in the way that you have.
 
@CarbsRok I've done basal testing and every time I test my bg stays level within the frame I'm testing. No thanks for your bluntness - my blood sugars have massively improved since having a pump and having made a positive change (i.e. going to the gym) I was thrown - this post was asking for some input I'm regretting posting it. I kind of knew i would need a basal reduction but didn't know how much or when. I was hoping someone with more experience could help out.

As for your comment regarding not utilising my pump what utter bull. I haven't had a HBa1c as low as my February one since before I was a teen and part of my utilising is having a CGM attached 24/7 as well. I self fund btw.

Regarding the CGM it's within 1mmol of monitor tests every time so what the hell is the point of testing every 2 hours?!

@Lucie75 Thanks for the support - really appreciate it.


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It was me thT wrote about testing.. Not carbroks because I was told that my cgm (navigator) was a guideline only... (Yes, they were inaccuate and calubrating from blood strips that read too low), however they are stll guidelines to whether your bloods are raising or lowering and a real bllod test should be more accurate.

Moving on... With a cgm it is possible to get much improved rates; my background retionopathy went when my levels didnt fluctuate. I have continued with blood testing since my 9 months with navigator and my retionpathy is still gone.

Carbsrok is right, sorry......


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donnellysdogs said:
It was me thT wrote about testing.. Not carbroks because I was told that my cgm (navigator) was a guideline only... (Yes, they were inaccuate and calubrating from blood strips that read too low), however they are stll guidelines to whether your bloods are raising or lowering and a real bllod test should be more accurate.

Moving on... With a cgm it is possible to get much improved rates; my background retionopathy went when my levels didnt fluctuate. I have continued with blood testing since my 9 months with navigator and my retionpathy is still gone.

Carbsrok is right, sorry......


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Hi Eng

Not sure if things are the same today as they where. If so, have a go with using a pen to deliver the meal bolus inztead of pump. If yr bg is still the same, then its either the basal or bolus not right anymore. If.bg is better with pen. then l
look at set and put it somwhete else to see if that helps with absorbtion. Lastly, its not unknown for some sets to be faulty
 
But my bloods aren't normally like this!

@donnellysdogs what blood results do you generally get pre and post meal? how do you achieve minimal spikes?

My BG have always spiked when eating carbs when injecting with a pen or not. Could anyone point out exactly whats wrong with my bloods here? is it the height of the spikes or? If it is the height thats because Ive eaten a fairly large portion of carbs (about 40-60g) at each of the spikes as well as knocking off some basal to try and raise my base rate. Each time I was eating I was dropping back to low 4's (still not comfortable with that).

I am utterly confused as I really thought I was doing so well :confused::(
 
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Yes, I would be concerned with those spikes, even if in normal range after the 4 hours. Just a bit ocd I suppose. When that happens, something not right. Could be a number of things. Finding out the cause, basal/bolus/gi/other, hope you get it sorted.

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Also, timing of bolus does need to be considered as I previously mentioned the spike of the food, not in correlation with the peak of insulin.

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Eng, I'm not on cgm, but might ask DSN due to issues I have and you've said about. But when I see her I say my bloods aren't what I would like. She puts me in my place(hubby, likes this point) and tells me that we all have blips as we don't have a working pancreas, so we won't get perfect results as injections/pump only play catch up, On our results. And my DSN REPORTS TO PROFESSOR AMIEL, first to help in an islet cell transplant at Kings, she harvested the cells. Take a deep breath and start again, mine have spiked over the last week, but told above 15 start to be concerned. Last night 16.9, after set set change then 18.9 half an hour later, with blood in the whole set, pump didn't alarm, but changed set. As hubby gripped at me to test 30 mins later rather than. 60. Glad he did ( can be a pain, but first time I fitted, scared the life out of him, now love him to bits, as been through a lot, but have given him 2 kids, which he loves, despite my diabetes). Take care and chin up. As hubby has just said diabetes effects all of us in different ways, pump incl( sometimes he speaks ****, but last sentence so true) all new users need help, but we don't need to be told we shouldn't have a pump. Those that have had a pump long term, think back(if you can). Did you have the information that we can get or ask for??? As newbies like Eng, Lucie and myself need are we all going to get the same response I've had great help from Eng and iHs and noblehead, on when my fingers and ears are sore for bg's, so now trying toes. But that info only came from members. And surely we should be helping and offering support, not make the person asking the question like they shouldn't have asked,this or hurt them, in a response?? They are just asking for advice and reasurance??
 
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40-60g carb per meal is not excessive...

My meal tonight was a quiche n salad and a greek yogurt.

I do not like to go above 2.8 from my pre meal bg. So initially I got my basal readings right so I can go without eating. Then I got bolus right.

I rarely do basal testing now, but if my levels are over 2.8 higher 2 hours after a meal I will adjust my bolus... This was told to me by my consultant, and apart from night time basal testing it really has stood me in good stead. I will never allow my 2hr after food bg to be less than pre meal.

I dont eat too much. I do have a yum yum pre and during 6 hours gardening, which I do as a job. Otherwise I may eat a piece of toast occasionally during day or a small bowl of porridge. A yogurt. Fruit and mainly salads.. I do go full out sometimes for takeaways and treats, dont get me wrong... But with pump if I do this, because its such a huge change for my body then my bolus can quadruple to my norm... In which case I also whack up my basal rate to 250%.. Even this isnt enough for these treats.. So they are rare treats. Once a month I have a bacon, brie and cranberry panini when I go out with friends. That is my monthly treat really.
Its taken a lot of practice on pump to achieve this.. But I am happy that I can eat anything.. Indeed I do when I want to, but my norm is enough food to keep me slim and healthy and only eat takeaways etc or cakes or excess at xmas, birthday and times out socialising with friends if we are eating out. If eating with friends n family I eat same as them.


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I'm currently working off the fact that when I downloaded my results tonight I compared them to a month ago. Then I had 36% in target (under 10) now I have 57% in target a month later. I think I'm doing really well as before the pump I was probably pushing 20% in target while eating carbs. I've only had a pump 4 months after all.

Obviously I'm not going to stop working towards better control but I think these improvements I'm making with the experience I have is all baby steps.

@donnellysdogs how long does it take for your insulin to start working? I find it used to take 2 hours from injecting for ANY insulin action to start so 2 hours post meal my bg is at it's very peak but very quickly falls thereafter. Any suggestions? I can't add Bolus as I eat different times every day.


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Eng, look at this way from a non diabetic(hubby:() he says we can't all perfect, lol). We all need help and we come here to ask for it.
 
I had huge help from a lady I have never met from this website. She gave me the biggest support ever when I went on pump 4 years ago. She is in my memory everyday. I never glforget the hours of phonecalls we had. I have also gone on to help 4 others by phone that I have never met. We have also stayed in contact by email and texts and talks.

I dont forget my first days ever. Or the help that I had.


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So donnellysdogs, all newbies need help and Guidence in using a pump, no matter how long we have been using one?? Would I be correct in asking this question as Eng and myself less than a year roug ( for Eng and mysrelf)
 
No, didnt say that, just that I had fantastic help from somebody from this forum who was available basically 24/7 when I started....she was fantastic. I still help others now... However, we always still learn from each orher, no matter how long we've been on a pump... I learn new things like last week when mine went t***s up... Almost 4 years on, I had never experienced all these error messages before.... And needed a new pump, and now a new handset....


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Hi Eng

I guess you have sorted this out now as it was a couple of weeks ago?

I would say that unexpected drops in BG are normal when start any new exercise regime that you are not used to.

Then you have taken carbs to compensate for the lows, causing the rebound effect.

So what I have found for these situations is that the following advice from DSNs works:

- expect lows when starting exercise or increasing your level of exercise significantly

- treat lows conservatively with just a few Glucotabs. Over correcting can set off swings, oscillations, as seen in your data

- don't correct strongly for highs arising from hypo correction, or after exercise, and especially both. This is the hardest advice for me to follow, it goes against instinct, but it's true.

The reason why is, after a hypo and after exercise, your body does glycogen replacement. This process pulls glucose out of the bloodstream for several hours, until the glycogen reserves in the liver and muscles are topped up again. The glycogen reserves are depleted during exercise and particularly during a hypo (particularly if you get adrenalin symptoms). The effect is particularly noticeable the first time you exercise and eases off once your body gets used to regular exercise.

If you combine these suggestions you should be fine with exercise. Reducing basal may also help somewhat, but keep in mind there is a delivery delay into the bloodstream from the skin just like with MDI. But if you reduce basal during the exercise, the blood glucose effect will be after the exercise, which is typically when you need it (because glycogen replenishment is driving blood glucose down, so you want less insulin in the blood).

Exercise and hypos used to really mess me about until I understood all this, actually believed it, and put it all together.

If you were just going regular exercise it would just be a matter of tweaking your basal. But because you are changing your level of exercise is what introduces these oscillations. In engineering terms: It's like any disturbance to a stable system introduces oscillations. You need to "damp down" the oscillations. Making moderate glucose corrections and then minimal insulin corrections to those glucose corrections, you can damp down the oscillations.

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